[논문]상악전방견인장치와 이모장치 및 고정식 교정장치 치료를 받은 III급 부정교합 환자의 치료효과에 대한 종단적 비교

이남기; 백승학

doi:10.4041/kjod.2009.39.6.362

상악전방견인장치와 이모장치 및 고정식 교정장치 치료를 받은 III급 부정교합 환자의 치료효과에 대한 종단적 비교
Comparison of longitudinal treatment effects with facemask and chincup therapy followed by fixed orthodontic treatment on Class III malocclusion 원문보기

대한치과교정학회지 = Korean journal of orthodontics, v.39 no.6, 2009년, pp.362 - 371

이남기 (Department of Orthodontics, School of Dentistry, Seoul National University) , 백승학 (Department of Orthodontics, School of Dentistry, Seoul National University)

초록
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본 연구는 상악전방견인장치 또는 이모장치 치료 후 고정식 교정장치로 치료 받은 III급 부정교합 환자의 치료효과에 대한 종단적 비교를 위해 시행되었다. 상악전방견인 치료 또는 이모장치 치료 전의 골격 및 치아 유형이 유사하며 고정식 교정치료 후 좋은 유지결과(I급 구치/견치 관계 및 양의 수직/수평피개)를 보이는 21명의 환자(1군, 상악전방견인장치, 11명; 2군, 이모장치, 10명)를 대상으로 하였다. 상악전방견인 치료 또는 이모장치 치료 전(T0)과 후(T1), 고정식 교정치료 후 유지기간(T2)에 측모두부방사선사진을 촬영하여 골격 및 치아에 대한 계측치를 이용하였다. 통계적 분석을 위해 비모수 검정법(Mann-Whitney U-test and Wilcoxon signed-rank test)을 이용하였다. 악정형 치료 시기(T0-T1)에, 1군에서는 상악골의 전방 이동 (point A, p < 0.05), 상악 전치의 순측경사 (p < 0.01) 및 수평피개의 증가 (p < 0.01)가 보였다. 하악골은 1군과 2군 모두에서 후방 위치를 보였다 (SNB, Pog-N perp, ANB, p < 0.01). 1군에서는 수직고경의 증가 (SN-GoGn, ANS-Me/N-Me, Bjork sum, p < 0.01)가 나타난 반면에, 2군에서는 articular angle의 증가 (p < 0.05)와 gonial angle의 감소 (p < 0.01)가 보였다. 고정식 교정치료 및 유지기간(T1-T2)에, 1군과 2군 모두는 상악골의 전방성장 (point A, p < 0.05)을 보였다. 한편 1군은 하악골의 전방성장 (Pog-N perp, p < 0.01) 및 반시계방향 회전 (SN- GoGn, Bjork sum, p < 0.05)과 하악 전치의 순측경사 (IMPA, p < 0.05)를 나타냈으며, 2군은 ANS-Me/N-Me의 증가 (p < 0.01)와 수직피개의 감소 (p < 0.05)를 보였다. 비록 상악전방견인 치료와 이모장치 치료의 골격 및 치성적 효과가 서로 차이가 있을지라도, 이 두 치료법으로 인한 결과가 장기간 안정적으로 유지되기 위해서 하악골의 회전 및 성장에 맞추어 상악골의 지속적인 전방성장이 필요한 것으로 생각된다.

Abstract ▼ AI-Helper

Objective: The purpose of this study was to compare the longitudinal treatment effects of facemask with rapid maxillary expansion (FM/RME) and chincup (CC) therapy followed by fixed orthodontic treatment (FOT) in Class III malocclusion (CIII) patients. Methods: The samples consisted of twenty-one CIII patients who had similar skeletal and dental characteristics before FM/RME or CC therapy and good retention results (Class I molar/canine relationship and positive overbite/overjet) after FOT (Group 1, FM/RME, n = 11; Group 2, CC, n = 10). Lateral cephalograms were taken before (T0) and after FM/RME or CC therapy (T1), and after FOT and retention (T2). Skeletal and dental variables were measured. Mann-Whitney U-test and Wilcoxon signed-rank test were used for statistical analysis. Results: During T0-T1, FM/RME therapy induced forward movement of point A, and labioversion of the upper incisors. Both groups showed posterior repositioning of the mandible. FM/RME resulted in increase of the vertical dimension; however, CC caused an increase in articular angle and decrease in gonial angle. During T1-T2, both groups exhibited forward growth of point A. Group 1 showed forward growth and counterclockwise rotation of the mandible and increase of IMPA; however, Group 2, showed increase of ANS-Me/N-Me and decrease of overbite. Conclusions: The key factor for successful FM/RME and CC therapy and good retention results might be a harmonized forward growth of the maxilla that could keep pace with the growth and rotation of the mandible.

주제어

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제안 방법

The cephalometric variables are listed in Table 1. Cephalometric tracing and measurements were performed by one investigator using a digitizer (Intuos2 graphic tablet, Wacom Technology Co, Vancouver, Canada) and VCeph software (CyberMed, Seoul, Korea) at units of 0.05 degrees and 0.05 mm. Five randomly selected sets of cephalograms were retraced and redigitized after 2 weeks to determine the level of error in the initial measurements.
05 mm. Five randomly selected sets of cephalograms were retraced and redigitized after 2 weeks to determine the level of error in the initial measurements. There was no significant difference between the measurements (Dahlberg’s formula, error of the linear measurement ＜ 0.
The samples consisted of twenty-one patients with Class III malocclusion who had similar skeletal and dental patterns, were treated by Delaire type FM/RME or Occipital pull CC, and exhibited good retention results after comprehensive fixed orthodontic treatment (approximately 5 years after the end of FM/RME or CC therapy). The criteria for good retention results consisted of a Class I canine and molar relationship, positive overbite and overjet, and a pleasing facial profile.
²⁹ To precisely compare the treatment effects of these appliances, a confined set of patients that have both similar skeletal and dental patterns prior to orthopedic treatment and good retention results after fixed orthodontic treatment are necessary. Therefore, the purpose of this retrospective study was to compare the longitudinal treatment effects of FM/RME and CC therapy followed by comprehensive fixed orthodontic treatment in patients with skeletal Class III malocclusion.

대상 데이터

The samples consisted of twenty-one patients with Class III malocclusion who had similar skeletal and dental patterns, were treated by Delaire type FM/RME or Occipital pull CC, and exhibited good retention results after comprehensive fixed orthodontic treatment (approximately 5 years after the end of FM/RME or CC therapy). The criteria for good retention results consisted of a Class I canine and molar relationship, positive overbite and overjet, and a pleasing facial profile.

데이터처리

Wilcoxon signed rank test was done. ^* Means comparison between T0 and T1 stages within the same group.
, Chicago, IL, USA) was used. Wilcoxon signed rank test was used to determine the difference between T0 and T1 stages and between T1 and T2 stages within the same group. Mann-Whitney test was used to compare the differences between Groups 1 and 2 during orthopedic therapy (T0-T1) and fixed orthodontic treatment and retention (T1-T2).

이론/모형

Mann-Whitney test was done. FM/RME means facemask with rapid maxillary expansion; CC, chincup; T0, before FM/RME or CC treatment; T1, after FM/RME or CC treatment; T2, after fixed orthodontic treatment and retention; SD, standard deviation; NS, not significant (p > 0.

참고문헌 (37)

Campbell PM. The dilemma of Class III treatment. Early or late? Angle Orthod 1983;53:175-91

상세보기
Guyer EC, Ellis EE 3rd, McNamara JA Jr, Behrents RG. Components of class III malocclusion in juveniles and adolescents. Angle Orthod 1986;56:7-30

상세보기
McNamara JA. An orthopedic approach to the treatment of Class III malocclusion in young patients. J Clin Orthod 1987;21:598-608
Ngan PW, Hagg U, Yiu C, Wei SH. Treatment response and long-term dentofacial adaptations to maxillary expansion and protraction. Semin Orthod 1997;3:255-64

상세보기
Park HC, Lee JW. Study of horizontal skeletal pattern and dental arch in skeletal Class III malocclusion patients. Korean J Orthod 2008;38:358-69

원문보기 상세보기
Turley PK. Orthopedic correction of Class III malocclusion with palatal expansion and custom protraction headgear. J Clin Orthod 1988;22:314-25
Turley PK. Orthopedic correction of Class III malocclusion: retention and phase II therapy. J Clin Orthod 1996;30:313-24

상세보기
Arman A, Ufuk Toygar T, Abuhijleh E. Evaluation of maxillary protraction and fixed appliance therapy in Class III patients. Eur J Orthod 2006;28:383-92

상세보기
Baik HS. Clinical results of the maxillary protraction in Korean children. Am J Orthod Dentofacial Orthop 1995;108:583-92

상세보기
Chong YH, Ive JC, Artun J. Changes following the use of protraction headgear for early correction of Class III malocclusion. Angle Orthod 1996;66:351-62

상세보기
Shanker S, Ngan P, Wade D, Beck M, Yiu C, H $\ddot{a}$ gg U, et al. Cephalometric A point changes during and after maxillary protraction and expansion. Am J Orthod Dentofacial Orthop 1996;110:423-30

상세보기
Kapust AJ, Sinclair PM, Turley PK. Cephalometric effects of face mask/expansion therapy in Class III children: a comparison of three age groups. Am J Orthod Dentofacial Orthop 1998;113:204-12

상세보기
Gallagher RW, Miranda F, Buschang PH. Maxillary protraction: treatment and posttreatment effects. Am J Orthod Dentofacial Orthop 1998;113:612-9

상세보기
Sung SJ, Baik HS. Assessment of skeletal and dental changes by maxillary protraction. Am J Orthod Dentofacial Orthop 1998;114:492-502

상세보기
Macdonald KE, Kapust AJ, Turley PK. Cephalometric changes after the correction of Class III malocclusion with maxillary expansion/facemask therapy. Am J Orthod Dentofacial Orthop 1999;116:13-24

상세보기
Arman A, Toygar TU, Abuhijleh E. Profile changes associated with different orthopedic treatment approaches in Class III malocclusions. Angle Orthod 2004;74:733-40

상세보기
Kama JD, Ozer T, Baran S. Orthodontic and orthopedic changes associated with treatment in subjects with Class III malocclusions. Eur J Orthod 2006;28:496-502

상세보기
Tortop T, Keykubat A, Yuksel S. Facemask therapy with and without expansion. Am J Orthod Dentofacial Orthop 2007;132:467-74

상세보기
Sakamoto T, Iwase I, Uka A, Nakamura S. A roentgenocephalometric study of skeletal changes during and after chin cup treatment. Am J Orthod 1984;85:341-50

상세보기
Sugawara J, Asano T, Endo N, Mitani H. Long-term effects of chincap therapy on skeletal profile in mandibular prognathism. Am J Orthod Dentofacial Orthop 1990;98:127-33

상세보기
Allen RA, Connolly IH, Richardson A. Early treatment of Class III incisor relationship using the chincap appliance. Eur J Orthod 1993;15:371-6

상세보기
Ishikawa H, Nakamura S, Kim C, Iwasaki H, Satoh Y, Yoshida S. Individual growth in Class III malocclusions and its relationship to the chin cap effects. Am J Orthod Dentofacial Orthop 1998;114:337-46

상세보기
Deguchi T, Kuroda T, Minoshima Y, Graber TM. Craniofacial features of patients with Class III abnormalities: growth-related changes and effects of short-term and long-term chincup therapy. Am J Orthod Dentofacial Orthop 2002;121:84-92

상세보기
Ko YI, Baek SH, Mah J, Yang WS. Determinants of successful chincup therapy in skeletal Class III malocclusion. Am J Orthod Dentofacial Orthop 2004;126:33-41

상세보기
Uner O, Y $\"{u}$ ksel S, U $\c{c}$ $\"{u}$ nc $\"{u}$ N. Long-term evaluation after chincap treatment. Eur J Orthod. 1995;17:135-41

상세보기
Ngan P, Yiu C, Hu A, H $\"{a}$ gg U, Wei SH, Gunel E. Cephalometric and occlusal changes following maxillary expansion and protraction. Eur J Orthod 1998;20:237-54

상세보기
Westwood PV, McNamara JA Jr, Baccetti T, Franchi L, Sarver DM. Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances. Am J Orthod Dentofacial Orthop 2003;123:306-20

상세보기
Pangrazio-Kulbersh V, Berger JL, Janisse FN, Bayirli B. Long-term stability of Class III treatment: rapid palatal expansion and protraction facemask vs LeFort I maxillary advancement osteotomy. Am J Orthod Dentofacial Orthop 2007;131:7.e9-19

상세보기
Uc $\"{u}$ nc $\"{u}$ N, U $\c{c}$ em TT, Y $\"{u}$ ksel S. A comparison of chincap and maxillary protraction appliances in the treatment of skeletal Class III malocclusions. Eur J Orthod 2000;22:43-51

상세보기
Hwang CJ, Moon JL. A retrospective study on profile having favorable response to Facemask. Korean J Orthod 1999;29:147-56
Mermigos J, Full CA, Andreasen G. Protraction of the maxillofacial complex. Am J Orthod Dentofacial Orthop 1990;98:47-55

상세보기
Merwin D, Ngan P, Hagg U, Yiu C, Wei SH. Timing for effective application of anteriorly directed orthopedic force to the maxilla. Am J Orthod Dentofacial Orthop 1997;112:292-9

상세보기
Ritucci R, Nanda R. The effect of chin cup therapy on the growth and development of the cranial base and midface. Am J Orthod Dentofacial Orthop 1986;90:475-83

상세보기
Hwang CI, Suhr CH. A roentgenocephalometric study on the effects of the chincap in the skeletal Class III malocclusion. Korean J Orthod 1989;19:219-44

원문보기 상세보기
Chen KF, So LL. Sagittal skeletal and dental changes of reverse headgear treatment in Chinese boys with complete unilateral cleft lip and palate. Angle Orthod 1996;66:363-72

상세보기
Mitani H, Sakamoto T. Chin cap force to a growing mandible. Long-term clinical reports. Angle Orthod 1984;54:93-122

상세보기
Wisth PJ, Tritrapunt A, Rygh P, B ${\o}$ e OE, Norderval K. The effect of maxillary protraction on front occlusion and facial morphology. Acta Odontol Scand 1987;45:227-37

상세보기

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